Migraine is a type of headache, which is a severe, seriously debilitating and usually unilateral form of episodic headache that may be preceded by aura and that is frequently associated with both neurological and gastrointestinal symptoms such as nausea, vomiting, diarrhea, sensitivity to light (photophobia), sound (phonophobia), and smells (osmophobia); sleep disruption, and depression. When untreated, a migraine headache attack may last anywhere from four to 72 hours. Migraines include cluster headaches and vascular headaches and are sometimes termed sick headaches or histamine headaches.
Migraine can be divided into two major subtypes: migraine without aura and migraine with aura. Migraine without aura (MO) is a clinical syndrome characterized by headache attacks lasting 4-72 hours. Typical characteristics of the headache are unilateral location, pulsating quality (throbbing), moderate or severe intensity, aggravation by physical activity (which causes a mechanical strain on meningeal blood vessels) and association with nausea, vomiting, photophobia and/or phonophobia. About 70% of subjects suffering from migraines have migraine without aura. In migraine with aura (MA), attacks are accompanied by reversible focal neurological symptoms (mostly visual, but also sensory or motor symptoms). Aura develops over 5-20 minutes and lasts for less than 60 minutes. Headache with the features of MO usually follows the aura. About 30% of subjects suffering from migraines have migraine with aura.
Other, less common, types of migraine exist and include migraine with prolonged aura (aura symptoms last longer than 60 minutes); migraine aura without headache; migraine with acute onset aura; basilar migraine which can be associated with vertigo, gait perturbances and/or loss of consciousness; ophthalmoplegic migraine associated with ocular paralysis, diplopia and/or ptosis; retinal migraine; and familial hemiplegic migraine associated with hemiparesis or hemiplegia.
Pharmacological interventions for the management of migraine can be categorized into two general strategies: prevention of pain and/or associated symptomology and treatment to relieve/stop the pain and associated symptomology. It is commonly held that prostaglandin activity is associated with migraine and that blocking the activity of prostaglandins is an effective treatment for migraines.